Master and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil.
Physical Therapy Service, Instituto de Assistência Médica ao Servidor Público Estadual, São Paulo, Brazil.
J Physiother. 2019 Oct;65(4):208-214. doi: 10.1016/j.jphys.2019.08.006. Epub 2019 Sep 11.
Does advice from a physiotherapist about the importance of staying physically active during hospitalisation improve activity, mobility, strength, length of stay, and complications in older inpatients? What barriers to physical activity during hospitalisation do older inpatients perceive?
Randomised controlled trial with concealed allocation, intention-to-treat analysis, and blinded assessment.
Sixty-eight people who were aged > 60 years and admitted to a university hospital ward.
In addition to usual hospital care, the experimental group received a booklet with content about the deleterious effects of hospitalisation and the importance of staying active during hospitalisation. The control group received usual hospital care only.
The amount of physical activity was measured via accelerometry during the hospital admission. Mobility was assessed using the de Morton Mobility Index (DEMMI), and muscle strength was assessed using a handgrip dynamometer. Length of stay and complications were extracted from hospital records. The barriers to staying active during hospitalisation were investigated via a questionnaire.
Accelerometry showed a mean between-group difference of 974 steps/day (95% CI 28 to 1919) in favour of the experimental group. The intervention also increased moderate-intensity physical activity and reduced sedentary time, although these effects might be trivially small. Experimental group participants were about one-fifth as likely to lose mobility during their hospital admission (two of 33) than control group participants (10 of 35), relative risk 0.21 (95% CI 0.05 to 0.90). Effects of the intervention were unclear regarding muscle strength, length of stay and incidence of complications between the groups. Patients reported that the main barriers to remaining active during hospitalisation were dyspnoea, lack of space, and fear of contracting infection.
In older inpatients, the addition of advice from a physiotherapist about maintaining activity during hospitalisation increases the level of physical activity and prevents loss of mobility.
ClinicalTrials.govNCT03297567.
物理治疗师关于住院期间保持身体活跃重要性的建议是否能提高老年人住院患者的活动量、移动能力、力量、住院时间和并发症？住院期间老年人感知到的身体活动障碍有哪些？
随机对照试验，设隐匿分组，意向治疗分析，盲法评估。
68 名年龄大于 60 岁并入住大学医院病房的患者。
除了常规医院护理外，实验组还收到了一本小册子，内容涉及住院的有害影响和住院期间保持活跃的重要性。对照组仅接受常规医院护理。
在住院期间通过加速度计测量身体活动量。使用 de Morton 移动指数（DEMMI）评估移动能力，使用握力计评估肌肉力量。住院时间和并发症从医院记录中提取。通过问卷调查住院期间保持活跃的障碍。
加速度计显示，实验组每天的平均步数差异为 974 步（95%CI28 至 1919），对实验组有利。干预措施还增加了中等强度的身体活动，减少了久坐时间，尽管这些效果可能微不足道。实验组患者在住院期间丧失移动能力的可能性比对照组患者低五分之一（33 名中的 2 名），相对风险 0.21（95%CI0.05 至 0.90）。干预对肌肉力量、住院时间和两组之间并发症的发生率的影响尚不清楚。患者报告说，住院期间保持活跃的主要障碍是呼吸困难、缺乏空间和担心感染。
在老年住院患者中，增加物理治疗师关于住院期间保持活动的建议可提高身体活动水平并预防移动能力丧失。
ClinicalTrials.govNCT03297567。
